Coronary arteriography in complicated acute myocardial infarction; clinical and angiographic correlates
|
|
- Lee Carpenter
- 5 years ago
- Views:
Transcription
1 Coronary arteriography in complicated acute myocardial ; clinical and angiographic correlates Luis M. de la Fuente, M.D. Buenos Aires, Argentina From January 1979 to June 30, 1979, we performed coronary arteriography in more than 350 patients with acute and subacute myocardial. The purpose of this paper is to study 301 patients with myocardial complicated in the acute and subacute period by (1) angina, (2) acute mitral regurgitation, (3) perforation of the interventricular septum, (4) ventricular fibrillation, (5) intractable recurrent ventricular tachycardia-fibrillation, (6) heart failure, and (7) cardiogenic shock (Table 1). The studies were performed within 6 hours to 30 days after acute and subacute myocardial and a few hours after the onset of complications. The coronary arteriograms were performed by the Sones technique without the aid of mechanical circulatory assistance, and there were no deaths associated with the studies. Acute and subacute myocardial was diagnosed by the clinical history, electrocardiogram, and serum enzyme levels. We consider only severe obstructions (>70% narrowing). Angina after acute and subacute myocardial Two hundred thirty-six patients had angina within 30 days of an acute and subacute myocardial 200
2 Fall 1980 Complicated acute myocardial 201 Table 1. Complicated acute and subacute myocardial ; severity of the obstruction in the artery responsible for the ; 301 patients Total obstruction Severe obstruction Angina after acute myocardial (64%) 85 (36%) Mitral insufficiency after acute myocardial infarc (80%) 3 (20%) tion Interventricular septal defect after acute myocar (66.3%) 6 (33.7%) dial Ventricular fibrillation 6 3 (50%) 3 (50%) Intractable recurrent ventricular tachycardia fi (80%) 3 (20%) brillation Heart failure 8 8 (100%) Cardiogenic shock 2 2 (100%) Table 2. Acute and subacute myocardial complicated by angina; 236 patients Acute 107 (45.4%) Transmural 215(91%) Subacute 129 (54.6%) Nontransmural 21 (9%) Electrocardiographic location of the acute and subacute myocardial by angiographic groups Group I II III IV VI Anteroseptal Anterior 33 Anterolateral Inferior 5 38 Posterior 4 9 Lateral Subendocardic anterior Subendocardic anterolateral _1 _5 _1 Total Group I II III IV V VI (Table 2). Usually the pain was severe, repetitive, and appeared at rest. We identify six different angiographic groups. 1 Group I. Severe obstruction of a coronary artery (>70%) without collateral circulation producing an area of smaller than the zone perfused by that artery, with a surrounding area of ischemia. The left ventriculogram shows an area of akinesia or hypokinesia smaller than the total zone irrigated by that artery. Group II. The same anatomy as that in group I, but in addition there are one or more severe obstructions in other coronary arteries. Group III. Total or subtotal obstruc-
3 202 Cleveland Clinic Quarterly Vol. 47, No. 3 tion of an artery that produces an smaller than the area irrigated by that artery because of collateral circulation to the affected zone. The artery that provides the collateral circulation as well as the remainder of the coronary arteries are free of severe obstructions. In many cases, the collateral circulation limits the extension of the, but is not sufficient to supply an adequate amount of oxygenated blood to the periinfarcted area that remains ischemic. The left ventriculogram shows a zone of hypokinesia or akinesia smaller than the total area perfused by the obstructed artery. Group IV. The same anatomical as in group III, associated with severe obstruction in another artery. If this artery is the one that provides the collateral circulation, the peri area is seriously jeopardized. Group V. Severe or total obstruction of a coronary artery, which produces an extensive (presumably corresponding to the total area perfused by that artery) associated with severe lesions in other coronary arteries. The ventriculogram shows an area of akinesia or dyskinesia corresponding to the area perfused by the obstructed artery. Group VI. Subtotal or total obstruction of an artery with development of a ventricular aneurysm associated with mild or moderate obstructive lesions. The genesis of the pain can be different for each group. In groups I and III, with severe lesions in a single vessel, the pain probably originates from ischemic tissue surrounding the infarcted area. In groups II and IV, the pain can arise either from the infarcted area or from another ischemic zone or both. In group V, the angina probably does not originate from the infarcted area, but from the ischemic regions produced by another artery. The angina in group VI has several possible causes. (1) Patch areas of ischemic tissue within the zone of the acute necrosis, (2) increased oxygen consumption (acute ventricular aneurysm), and (3) underestimation of the severity of the obstruction in the other arteries. Prognostic implications In groups I and II, complete obstruction of the involved vessel can produce the extension of the previous or a new. We believe that in group III, the collateral circulation tends to improve oxygen supply to the ischemic area with time. Some of these patients had normal ergometric tests several months after the acute episode. Patients in group IV have the high risk of a new and extension of the previous one if the artery that provides the collateral circulation became completely obstructed. In group V, the infarcted area is large and a new infarct will cause a severe left ventricular impairment. In group VI, the prognosis is closely related to the evolution of an acute left ventricular aneurysm. In groups III and VI, if the pain episodes are not associated with ventricular arrhythmias or pump failure, medical treatment is indicated. We believe that postacute myocardial angina is a distinct entity with characteristic clinical and angiographic and with a clear-cut indication for coronary arteriography. Mitral regurgitation postacute myocardial Severe mitral regurgitation usually is a catastrophic complication of acute and subacute myocardial, having an incidence of approximately 1%. 3 The mitral regurgitation is produced by rupture or dysfunction of a
4 Fall 1980 Complicated acute myocardial 203 papillary muscle. Papillary muscle dysfunction is more common than rupture and can produce mild to severe mitral regurgitation. 4 Electrocardiographic location of is inferior with rupture of the posterior papillary muscle and anterolateral muscle when the anteromedial muscle is affected. 5 The clinical and angiographic of 15 patients are listed in Table 3. Thirteen patients had multiple-vessel obstructive lesions. Two patients had single-vessel disease, the right coronary artery in one patient and circumflex in the other. Rupture or dysfunction of a papillary muscle occasionally can be produced by a single-vessel obstruction. Cardiac catheterization should be associated with coronary angiography because of the high incidence of multiplevessel disease in these patients. The studies should be performed in the acute phase to quantitate the hemodynamic Table 3. Mitral insufficiency after acute myocardial ; 15 patients* Clinical Left ventricular failure 11 Acute pulmonary edema 3 Cardiogenic shock 1 Electrocardiographic location of the acute myocardial Inferior wall 14 Anterior wall 1 Angiographic Multiple obstructions 13 2 vessels, RCA and Cx 1 3 vessels, (LMT, 2 patients) 12 Single obstruction 2 RCA 1 Cx 1 * Men, 13; women, 2. Mean age, 54 years; range 38 to 68 years. RCA = right coronary artery, Cx = artery, LMT = left main trunk. circumflex alterations, the mitral regurgitation, delineate the coronary anatomy and the abnormalities of the left ventricle. Interventricular septal defect postacute myocardial Rupture of the ventricular septum is a rare complication of acute and subacute myocardial. It occurs in only 0.5% to 1% of patients with transmural myocardial. 6 The superposition of a large left-to-right shunt upon acute and subacute myocardial is usually a catastrophic Table 4. Interventricular septal defect after acute myocardial ; 19 patients* Time between the acute and the rupture of the ventricular septum 24 hr 2 2 days 3 3 days 4 4 days 2 5 days 4 7 days 1 8 days 1 10 days 2 Clinical Congestive heart failure 7 Left ventricular failure 10 Cardiogenic shock 2 Electrocardiographic locations of the acute myocardial Inferior wall 11 Anterior wall 8 Angiographic Multiple obstructions 11 2 vessels 8 3 vessels 3 Single obstruction 8 RCA 4 ADA 4 Left ventricular aneurysm 11 Anteroapical 6 Diaphragmatic 5 * Men, 13; women, 6. Mean age, 60 years; range, 43 to 81 years. ADA = anterior descending artery.
5 204 Cleveland Clinic Quarterly Vol. 47, No. 3 event, and the frequent association of ventricular septal defect with acute ventricular aneurysm worsen the clinical and hemodynamic deterioration. Rupture is most frequently located in the lower portion of the septum. The defect is usually single and its size may vary from 1 mm to 4 cm. 7 Table 4 lists the clinical, electrocardiographic, and angiographic in 19 patients. Eleven patients had multiple-vessel lesions. Single-vessel disease was present in eight patients, and the right coronary artery and the anterior descending artery were responsible for the acute and subacute myocardial. These show that single obstruction of the right coronary artery or the anterior descending artery can occasionally produce perforation of the interventricular septum. If surgical treatment is considered, cardiac catheterization and coronary arteriography should be performed and concomitant coronary bypass and/or reconstruction of the left ventricle should be done if indicated. Acute myocardial complicated with primary ventricular fibrillation Ventricular flutter or fibrillation is the most critical cardiac arrhythmia that complicates acute and subacute myocardial. Its incidence is estimated to be about 10%. 8,9 Table 5 shows the angiographic in six patients with an acute myocardial complicated by an episode of primary ventricular fibrillation. Intractable recurrent primary ventricular tachycardia-fibrillation Primary recurrent ventricular tachycardia-fibrillation is one of the most serious complications of an acute myocardial. The prognosis is very Table 5. Acute myocardial complicated by ventricular fibrillation; 6 patients Anterolateral wall 2 Anterior wall 1 Anteroseptal wall 1 Inferior wall 2 Angiographic Multiple obstructions 3 2 vessels, ADA, RCA 2 3 vessels 1 Single obstruction 3 ADA 1 RCA 2 Table 6. Intractable recurrent primary ventricular tachycardia-fibrillation complicating acute and subacute myocardial ; 15 patients Appearance of arrhythmias in evolution of myocardial 1st week 2 2nd week 1 3rd week 2 4th week 10 Electrocardiographic location of the acute and subacute myocardial Anterolateral wall 4 Anterior wall 7 Inferior wall 3 Lateral wall 1 Arrhythmias present in these patients Patients No. % Ventricular premature contrac tions Ventricular tachycardia Ventricular fibrillation Ventricular flutter 2 13 Multiple obstruction 11 2 vessels: 3 patients 3 vessels: 8 patients Single obstruction, ADA 4 Acute anteroapical ventricular 8 aneurysm
6 Fall 1980 Complicated acute myocardial 205 Table 7. Heart failure; 8 patients Electrocardiographic location of acute myocardial Anterior wall 7 Inferior wall 1 Previous myocardial 5 Multiple obstruction 6 2 vessels 3 3 vessels 3 Single obstruction, ADA 2 Acute ventricular aneurysms 6 poor either with pharmacological or electrical measures. 10 Table 6 shows the clinical, electrocardiographic, and angiographic in 15 patients with this complication. Emergency coronary arteriography allows the detection of operable defects in many of these patients (coronary artery bypass or infarctectomy or both). Heart failure Table 7 shows the electrocardiographic and angiographic in eight patients with acute myocardial complicated by left ventricular failure. Coronary angiography is indicated in these patients to rule out a left ventric- Table 8. Cardiogenic shock; 2 patients Electrocardiographic location of acute myocardial Anterior wall 2 patients (All patients had a previous inferior wall myocardial ) ADA, 100% 1 patient, RCA, 95% Cx, 100% Multiple obstruction: ADA, 100% 1 patient, RCA, 100% Cx, 40% 2 patients ular aneurysm and to decide the adequate treatment. Cardiogenic shock Cardiogenic shock is one of the most serious complications of acute myocardial. Depression of cardiac performance in acute myocardial is directly related to extent of myocardial damage. Myocardial destruction in shock usually is over 40% of the left ventricular mass. 11 The left ventriculogram in these patients shows severe and diffuse dysynergy of the left ventricular myocardium Table 8 lists the electrocardiographic and angiographic in these patients.
Common Codes for ICD-10
Common Codes for ICD-10 Specialty: Cardiology *Always utilize more specific codes first. ABNORMALITIES OF HEART RHYTHM ICD-9-CM Codes: 427.81, 427.89, 785.0, 785.1, 785.3 R00.0 Tachycardia, unspecified
More informationMyocardial Infarction
Myocardial Infarction MI = heart attack Defined as necrosis of heart muscle resulting from ischemia. A very significant cause of death worldwide. of these deaths, 33% -50% die before they can reach the
More informationSection V. Objectives
Section V Landscape of an MI Objectives At the conclusion of this presentation the participant will be able to Outline a systematic approach to 12 lead ECG interpretation Demonstrate the process for determining
More informationIschemic heart disease
Ischemic heart disease Introduction In > 90% of cases: the cause is: reduced coronary blood flow secondary to: obstructive atherosclerotic vascular disease so most of the time it is called: coronary artery
More information1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI).
1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI). 5- cardiogenic shock (massive MIs >40% of the left ventricle)
More informationCoronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening
Coronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening E O Dwyer 1, C O Brien 1, B Loo 1, A Snow Hogan 1, O Buckley1 2, B 1. Department
More informationNOT ANOTHER TALK ABOUT A - FIB
NOT ANOTHER TALK ABOUT A - FIB CASES KUDOS AND A CHALLENGE Case 1 67 y/o female s/p R mastectomy 3 months earlier Second course of adjuvant chemotherapy Muga scan E.F. 35% What do we do next? Case 1 Cardiology
More informationMYOCARDIALINFARCTION. By: Kendra Fischer
MYOCARDIALINFARCTION By: Kendra Fischer Outline Definition Epidemiology Clinical Aspects Treatment Effects of Exercise Exercise Testing Exercise Rx Summary and Conclusions References Break it down MYOCARDIAL
More informationListing Form: Heart or Cardiovascular Impairments. Medical Provider:
Listing Form: Heart or Cardiovascular Impairments Medical Provider: Printed Name Signature Patient Name: Patient DOB: Patient SS#: Date: Dear Provider: Please indicate whether your patient s condition
More informationHeart disease remains the leading cause of morbidity and mortality in industrialized nations. It accounts for nearly 40% of all deaths in the United
Heart disease remains the leading cause of morbidity and mortality in industrialized nations. It accounts for nearly 40% of all deaths in the United States, totaling about 750,000 individuals annually
More informationSurgical Management of Ventricular Septa1 Defects and Mitral Regurgitation Complicating Acute Myocardial Infarction
Surgical Management of Ventricular Septa1 Defects and Mitral Regurgitation Complicating Acute Myocardial Infarction Mortimer J. Huckley, M.D., Eldred D. Mundth, M.D., Willard M. Daggett, M.D., Herman K.
More informationIschemic Mitral Regurgitation
Ischemic Mitral Regurgitation 1 / 6 2 / 6 3 / 6 Ischemic Mitral Regurgitation Background Myocardial infarction (MI) can directly cause (IMR), which has been touted as an indicator of poor prognosis in
More informationDistribution of Arterial Lesions Demonstrated by Selective Cinecoronary Arteriography
Distribution of Arterial Lesions Demonstrated by Selective Cinecoronary Arteriography By WILLIAM L. PROUDFIT, M.D., EARL K. SHIREY, M.D., AND F. MASON SONES, JR., M.D. SUMMARY The distribution of obstructions
More informationThe Heart. Happy Friday! #takeoutyournotes #testnotgradedyet
The Heart Happy Friday! #takeoutyournotes #testnotgradedyet Introduction Cardiovascular system distributes blood Pump (heart) Distribution areas (capillaries) Heart has 4 compartments 2 receive blood (atria)
More information12 Lead ECGs: Ischemia, Injury & Infarction. Kevin Handke NRP, FP-C, CCP, CMTE STEMI Coordinator Flight Paramedic
12 Lead ECGs: Ischemia, Injury & Infarction Kevin Handke NRP, FP-C, CCP, CMTE STEMI Coordinator Flight Paramedic None Disclosures Objectives Upon completion of this program the learner will be able to
More information2. Case Report. 1. Introduction
Case Reports in Cardiology Volume 2016, Article ID 3251032, 5 pages http://dx.doi.org/10.1155/2016/3251032 Case Report Ventricular Septal Perforation after Biventricular Takotsubo Cardiomyopathy Successfully
More informationCardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition
Cardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition Table of Contents Volume 1 Chapter 1: Cardiovascular Anatomy and Physiology Basic Cardiac
More informationCoronary arteriographic study of mild angina
British HeartJournal, I975, 37, 752-756. Coronary arteriographic study of mild angina W. Walsh, A. F. Rickards, R. Balcon From the National Heart Chest Hospitals, London Chest Hospital, London The results
More informationLeft Ventricular Wall Resection for Aneurysm and Akinesia due to Coronary Artery Disease: Fifty Consecutive Patients
Left Ventricular Wall Resection for Aneurysm and Akinesia due to Coronary Artery Disease: Fifty Consecutive Patients Armand A. Lefemine, M.D., Rajagopalan Govindarajan, M.D., K. Ramaswamy, M.D., Harrison
More information12 Lead ECG Interpretation
12 Lead ECG Interpretation Julie Zimmerman, MSN, RN, CNS, CCRN Significant increase in mortality for every 15 minutes of delay! N Engl J Med 2007;357:1631-1638 Who should get a 12-lead ECG? Also include
More informationIndications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014
Indications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014 Indications for cardiac catheterization Before a decision to perform an invasive procedure such
More informationA DAYS CARDIOVASCULAR UNIT GUIDE DUE WEDNESDAY 4/12
A DAYS CARDIOVASCULAR UNIT GUIDE DUE WEDNESDAY 4/12 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 3/20 - B 3/21 - A 3/22 - B 3/23 - A 3/24 - B 3/27 - A Dissection Ethics Debate 3/28 - B 3/29 - A Intro to Cardiovascular
More informationAortocoronary Artery Graft During Early and Late Phases of Acute Myocardial Infarction
Aortocoronary Artery Graft During Early and Late Phases of Acute Myocardial Infarction Chalit Cheanvechai, M.D., Donald B. Effler, M.D., Floyd D. Loop, M.D., Laurence K. Groves, M.D., William C. Sheldon,
More informationEcho in CAD: Wall Motion Assessment
Echo in CAD: Wall Motion Assessment Joe M. Moody, Jr, MD UTHSCSA and STVHCS October 2007 Relevant References ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography Bayes de
More informationAnatomy of the Heart and the. ICD-10 Codes
Anatomy of the Heart and the Diseases ICD-10 Codes Sharon J. Oliver CPC, CPMA, CPC-I All Rights Reserved 1 Anatomy of the Heart Pulmonary Tricuspid (AV) Valve Mitral Aortic Semilunar Valve Chordae Tendineae
More informationCardiology/Cardiothoracic
Cardiology/Cardiothoracic ICD-9-CM to ICD-10-CM Code Mapper 800-334-5724 www.contexomedia.com 2013 ICD-9-CM 272.0 Pure hypercholesterolemia 272.2 Mixed hyperlipidemia 272.4 Other and hyperlipidemia 278.00
More informationIndex of subjects. effect on ventricular tachycardia 30 treatment with 101, 116 boosterpump 80 Brockenbrough phenomenon 55, 125
145 Index of subjects A accessory pathways 3 amiodarone 4, 5, 6, 23, 30, 97, 102 angina pectoris 4, 24, 1l0, 137, 139, 140 angulation, of cavity 73, 74 aorta aortic flow velocity 2 aortic insufficiency
More informationCoronary artery disease in patients dying from cardiogenic shock or congestive heart failure in the setting of acute myocardial infarction
British Heart Journal, 1976, 38, 906-910. Coronary artery disease in patients dying from cardiogenic shock or congestive heart failure in the setting of acute myocardial infarction Frans J. Wackers, K.
More information12 Lead Electrocardiogram (ECG) PFN: SOMACL17. Terminal Learning Objective. References
12 Lead Electrocardiogram (ECG) PFN: SOMACL17 Slide 1 Terminal Learning Objective Action: Communicate knowledge of 12 Lead Electrocardiogram (ECG) Condition: Given a lecture in a classroom environment
More informationBlood supply of the Heart & Conduction System. Dr. Nabil Khouri
Blood supply of the Heart & Conduction System Dr. Nabil Khouri Arterial supply of Heart Right coronary artery Left coronary artery 3 Introduction: Coronary arteries - VASAVASORUM arising from aortic sinuses
More informationCase Report Preoperative Assessment of Anomalous Right Coronary Artery Arising from the Main Pulmonary Artery
Case Reports in Medicine Volume 2011, Article ID 642126, 4 pages doi:10.1155/2011/642126 Case Report Preoperative Assessment of Anomalous Right Coronary Artery Arising from the Main Pulmonary Artery Marshall
More informationComplications of Acute Myocardial Infarction
Acute Myocardial Infarction Complications of Acute Myocardial Infarction Diagnosis and Treatment JMAJ 45(4): 149 154, 2002 Hiroshi NONOGI Director, Division of Cardiology and Emergency Medicine, National
More informationCoronary artery surgery results In The Survey Committee of Japanese Association for Coronary Artery Surgery (JACAS)
Coronary artery surgery results In 2017 The Survey Committee of Japanese Association for Coronary Artery Surgery (JACAS) Coronary artery bypass grafting (CABG), 2017 Total cases : 12,584 Isolated CABG
More informationA case of post myocardial infarction ventricular septal rupture CHRISTOFOROS KOBOROZOS, MD
A case of post myocardial infarction ventricular septal rupture CHRISTOFOROS KOBOROZOS, MD NAVAL HOSPITAL OF ATHENS case presentation Female, 81yo Hx: diabetes mellitus, hypertension, chronic anaemia presented
More informationCoronary Arterial and Left Ventriculographic Findings in Patients with Double-Vessel Disease and Angina Pectoris*,t
Clin. Cardiol. 3,246-251 (1 980) 0 G. Witzstrock Publishing House, Inc. Coronary Arterial and Left Ventriculographic Findings in Patients with Double-Vessel Disease and Angina Pectoris*,t W.V.R. VIEWEG.
More informationCardiomyopathic syndrome due to coronary artery
British Heart Journal, 1977, 39, 733-739 Cardiomyopathic syndrome due to coronary artery disease' I. Relation to angiographic extent of coronary disease and to remote myocardial infarction HAROLD DASH,
More informationThe Relationship between P rola psing Mitral Leaflet Syndrome and Angina and Normal Coronary Arteriograms*
The Relationship between P rola psing Mitral Leaflet Syndrome and Normal Coronary Arteriograms* F. Khan Nakh;avan, M.D., F.C.C.P.; Gangaiah Natara;an, M.B., B.S.;t Paravasthu Seshachary, M.D.;:j: and Harry
More informationHeart failure congestive heart failure, or CHF
Heart failure Heart failure (also called congestive heart failure, or CHF) is a frequent end point of many of the conditions In the United States alone, CHF affects nearly 5 million individuals annually,
More informationSurgical Treatment of Papillary Muscle Rupture
Surgical Treatment of Papillary Muscle Rupture Duncan A. Killen, M.D., William A. Reed, M.D., Suchint Wathanacharoen, M.D., Gary Beauchamp, M.D., and Barry Rutherford, M.D. ABSTRACT Between 1971 and 1979,
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acute coronary syndrome(s), anticoagulant therapy in, 706, 707 antiplatelet therapy in, 702 ß-blockers in, 703 cardiac biomarkers in,
More informationIschemic Heart Diseases. Dr. Nabila Hamdi MD, PhD
Ischemic Heart Diseases Dr. Nabila Hamdi MD, PhD ILOs Compare and contrast the different types of angina regarding their pathogenesis, clinical manifestations and evolution. Discuss myocardial infarct,
More informationPercutaneous coronary intervention of RIMA. The real challenge!
Percutaneous coronary intervention of RIMA The real challenge! Speaker's name: I do not have any potential conflict of interest Clinical Case 76-year old woman Previous History Actual Disease Diabetes
More informationSUPPLEMENTAL MATERIAL
SUPPLEMENTAL MATERIAL Table S1: Number and percentage of patients by age category Distribution of age Age
More informationRole of Early 2D Echocardiography in Patient with Acute Myocardial Infarction in Correlation with Electrocardiography and Clinical Presentation
MVP Journal of Medical Sciences, Vol 1(2), 51 55, July 2014 Role of Early 2D Echocardiography in Patient with Acute Myocardial Infarction in Correlation with Electrocardiography and Clinical Presentation
More informationBasic Coronary Angiography DAVID SHAVELLE MD
Basic Coronary Angiography DAVID SHAVELLE MD Basic Coronary Angiography: Take Home Points Cardiovascular Medicine Boards and Clinical Practice Understand normal coronary anatomy Understand different imaging
More informationP F = R. Disorder of the Breast. Approach to the Patient with Chest Pain. Typical Characteristics of Angina Pectoris. Myocardial Ischemia
Disorder of the Breast Approach to the Patient with Chest Pain Anthony J. Minisi, MD Department of Internal Medicine, Division of Cardiology Virginia Commonwealth University School of Medicine William
More informationin Patients Having Aortic Valve Replacement John T. Santinga, M.D., Marvin M. Kirsh, M.D., Jairus D. Flora, Jr., Ph.D., and James F. Brymer, M.D.
Factors Relating to Late Sudden Death in Patients Having Aortic Valve Replacement John T. Santinga, M.D., Marvin M. Kirsh, M.D., Jairus D. Flora, Jr., Ph.D., and James F. Brymer, M.D. ABSTRACT The preoperative
More informationEmergency surgery in acute coronary syndrome
Emergency surgery in acute coronary syndrome Teerawoot Jantarawan Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
More informationUniversity Journal of Medicine and Medical Sciences
ISSN 2455-2852 Volume 2 issue 1 2016 Infantile Heart Failure, Exotic Diagnosis but Dismal Prognosis LIJO VARGHESE PUTHENMADOM Department of Cardiology, CHRISTIAN MEDICAL COLLEGE Abstract : Infantile heart
More informationANATOMICAL IMAGING USING 3D ECHOCARDIOGRAPHY IN PATIENTS WITH MECHANICAL COMPLICATIONS POST MYOCARDIAL INFARCTION
Revista Română de Anatomie funcţională şi clinică, macro- şi microscopică şi de Antropologie Vol. XIV Nr. 2 2015 UPDATES ANATOMICAL IMAGING USING 3D ECHOCARDIOGRAPHY IN PATIENTS WITH MECHANICAL COMPLICATIONS
More informationThe Cardiovascular System. Chapter 15. Cardiovascular System FYI. Cardiology Closed systemof the heart & blood vessels. Functions
Chapter 15 Cardiovascular System FYI The heart pumps 7,000 liters (4000 gallons) of blood through the body each day The heart contracts 2.5 billion times in an avg. lifetime The heart & all blood vessels
More informationEchocardiographic visualization of the anatomic causes of mitral regurgitation
Postgraduate Medical Journal (May 1982) 58, 257-263 PAPERS Echocardiographic visualization of the anatomic causes of mitral regurgitation resulting from myocardial infarction ROBERT M. DONALDSON M.R.C.P.
More informationAppendix D Output Code and Interpretation of Analysis
Appendix D Output Code and Interpretation of Analysis 8 Arrhythmia Code No. Description 8002 Marked rhythm irregularity 8110 Sinus rhythm 8102 Sinus arrhythmia 8108 Marked sinus arrhythmia 8120 Sinus tachycardia
More informationANOMALOUS BRANCHING PATTERN OF CORONARY VESSELS
ANOMALOUS BRANCHING PATTERN OF CORONARY VESSELS *Y. Mamatha and Chaitanya Sridhar Department of Anatomy, Hassan Medical College, Karnataka *Author for Correspondence ABSTRACT Anatomical variations in relation
More informationJournal of the American College of Cardiology Vol. 37, No. 2, by the American College of Cardiology ISSN /01/$20.
Journal of the American College of Cardiology Vol. 37, No. 2, 2001 2001 by the American College of Cardiology ISSN 0735-1097/01/$20.00 Published by Elsevier Science Inc. PII S0735-1097(00)01133-5 Coronary
More informationCardiovascular Disorders Lecture 3 Coronar Artery Diseases
Cardiovascular Disorders Lecture 3 Coronar Artery Diseases By Prof. El Sayed Abdel Fattah Eid Lecturer of Internal Medicine Delta University Coronary Heart Diseases It is the leading cause of death in
More informationYour heart is a muscular pump about the size of your fist, located
How Your Heart Works Your heart is a muscular pump about the size of your fist, located slightly to the left and behind your breastbone. Its function is to pump blood throughout your body. As your heart
More informationImaging of Coronary Artery Disease: II
Acta Radiológica Portuguesa, Vol.XIX, nº 74, pág. 45-51, Abr.-Jun., 2007 Imaging of Coronary Artery Disease: II Jean Jeudy University of Maryland School of Medicine Department of Diagnostic Radiology Armed
More informationAlex versus Xience Registry Preliminary report
Interventional Cardiology Network Alex versus Xience Preliminary report Mariusz Gąsior 1,2, Marek Gierlotka 1, Lech Poloński 1,2 1 3rd Department of Cardiology, Medical University of Silesia Centre tor
More informationMI Acute occlusion of the proximal left anterior descending (LAD) artery is the cause of 40% to 50% of all MIs. *
MI *33% -50% die before hospital lethal arrhythmia Sudden Cardiac Death. * Arrhythmias are caused by electrical abnormalities of the ischemic myocardium and conduction system. *Acute occlusion of the proximal
More information2/14/2018 CASE STUDIES: COMPLICATIONS OF MYOCARDIAL INFARCTION. Judy Hung, MD Cardiology Division Massachusetts General Hospital Boston, MA CASE 1
CASE STUDIES: COMPLICATIONS OF MYOCARDIAL INFARCTION Judy Hung, MD Cardiology Division Massachusetts General Hospital Boston, MA CASE 1 1 PRESENTATION 57 yo male with a past medical history of hypertension
More informationHeart Disorders. Cardiovascular Disorders (Part B-1) Module 5 -Chapter 8. Overview Heart Disorders Vascular Disorders
Cardiovascular Disorders (Part B-1) Module 5 -Chapter 8 Overview Heart Disorders Vascular Disorders Susie Turner, MD 1/7/13 Heart Disorders Coronary Artery Disease Cardiac Arrhythmias Congestive Heart
More informationCurrent Guidelines for Diagnosis of AMI Chest pain ST change on EKG Cardiac Enzymes
Noninvasive Cardiac Imaging in Myocardial Infarction Sangchol Lee Sungkyunkwan University Samsung Medical Center Current Guidelines for Diagnosis of AMI Chest pain ST change on EKG Cardiac Enzymes Do We
More informationAcute Coronary Syndrome. Sonny Achtchi, DO
Acute Coronary Syndrome Sonny Achtchi, DO Objectives Understand evidence based and practice based treatments for stabilization and initial management of ACS Become familiar with ACS risk stratification
More informationEAE Teaching Course. Magnetic Resonance Imaging. Competitive or Complementary? Sofia, Bulgaria, 5-7 April F.E. Rademakers
EAE Teaching Course Magnetic Resonance Imaging Competitive or Complementary? Sofia, Bulgaria, 5-7 April 2012 F.E. Rademakers Complementary? Of Course N Engl J Med 2012;366:54-63 Clinical relevance Treatment
More informationJ. Schwitter, MD, FESC Section of Cardiology
J. Schwitter, MD, FESC Section of Cardiology CMR Center of the CHUV University Hospital Lausanne - CHUV Switzerland Centre de RM Cardiaque J. Schwitter, MD, FESC Section of Cardiology CMR Center of the
More informationCARDIAC AND CORONARY ARTERY ANATOMY NO DISCLOSURES. Axial Anatomy of Heart. Axial Anatomy of Heart. Axial Anatomy of Heart
CARDIAC AND CORONARY ARTERY ANATOMY NO DISCLOSURES NASCI MEETING, ORLANDO FLORIDA 2009 KOSTAKI G. BIS, MD, FACR DEPARTMENT OF RADIOLOGY WILLIAM BEAUMONT HOSPITAL Royal Oak, Michigan OBJECTIVES CARDIAC
More informationand Coronary Artery Surgery George M. Callard, M.D., John B. Flege, Jr., M.D., and Joseph C. Todd, M.D.
Combined Valvular and Coronary Artery Surgery George M. Callard, M.D., John B. Flege, Jr., M.D., and Joseph C. Todd, M.D. ABSTRACT Between July, 97, and March, 975,45 patients underwent combined valvular
More informationMyocardial infarction
CHAPTER-I CARDIOVASCULAR SYSTEM Myocardial infarction SUB: PHARMACOTHERAPEUTICS-I CODE:T0820006 Dr. Venugopal Pharm.D Assistant Professor Department of Pharm.D Kriahna Teja Pharmacy College,Tirupati. Definition
More informationABNORMAL ORIGIN OF THE LEFT CIRCUMFLEX CORONARY ARTERY FROM THE RIGHT CORONARY ARTERY
ABNORMAL ORIGIN OF THE LEFT CIRCUMFLEX CORONARY ARTERY FROM THE RIGHT CORONARY ARTERY Antonio Fuertes, M.D.,* Mario Trivellato, M.D.,** and Jeff Z. Brooker, M.D.*** INTRODUCTION Primary anomalies of the
More informationAbnormal, Autoquant Adenosine Myocardial Perfusion Heart Imaging. ID: GOLD Date: Age: 46 Sex: M John Doe Phone (310)
Background: Reason: preoperative assessment of CAD, Shortness of Breath Symptom: atypical chest pain Risk factors: hypertension Under influence: a beta blocker Medications: digoxin Height: 66 in. Weight:
More informationArrhythmic Complications of MI. Teferi Mitiku, MD Assistant Clinical Professor of Medicine University of California Irvine
Arrhythmic Complications of MI Teferi Mitiku, MD Assistant Clinical Professor of Medicine University of California Irvine Objectives Brief overview -Pathophysiology of Arrhythmia ECG review of typical
More informationAtherosclerotic Heart Disease: Coronary Vessels, EKG Localization of STEMI and Complications/Derivatives for USMLE Step One
Atherosclerotic Heart Disease: Coronary Vessels, EKG Localization of STEMI and Complications/Derivatives for USMLE Step One Howard J. Sachs, MD Associate Professor of Medicine University of Massachusetts
More informationAP2 Lab 3 Coronary Vessels, Valves, Sounds, and Dissection
AP2 Lab 3 Coronary Vessels, Valves, Sounds, and Dissection Project 1 - BLOOD Supply to the Myocardium (Figs. 18.5 &18.10) The myocardium is not nourished by the blood while it is being pumped through the
More informationCOLLATERAL FUNCTION IN PATIENTS WITH CORONARY OCCLUSION EVALUATED BY 201 THALLIUM SCINTIGRAPHY
& COLLATERAL FUNCTION IN PATIENTS WITH CORONARY OCCLUSION EVALUATED BY 201 THALLIUM SCINTIGRAPHY Aida Hasanović * Institute of Anatomy, University of Sarajevo, Faculty of Medicine, Čekaluša 90, 71 000
More informationAlcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy. CardioVascular Research Foundation
Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy Alcohol Septal Ablation (ASA) Nonsurgical technique for septal myocardial reduction Dramatic hemodynamic improvement Technically easy
More informationCoronary artery surgery results In The Survey Committee of Japanese Association for Coronary Artery Surgery (JACAS)
Coronary artery surgery results In 2016 The Survey Committee of Japanese Association for Coronary Artery Surgery (JACAS) Coronary artery bypass grafting (CABG), 2016 Total cases : 12,729 Isolated CABG
More informationChapter 14 Cardiovascular Emergencies Cardiovascular Emergencies Cardiovascular disease has been leading killer of Americans since.
1 2 3 4 5 Chapter 14 Cardiovascular Emergencies Cardiovascular Emergencies Cardiovascular disease has been leading killer of Americans since. Accounts for 1 of every 2.8 deaths Cardiovascular disease (CVD)
More informationCardiovascular Disorders. Heart Disorders. Diagnostic Tests for CV Function. Bio 375. Pathophysiology
Cardiovascular Disorders Bio 375 Pathophysiology Heart Disorders Heart disease is ranked as a major cause of death in the U.S. Common heart diseases include: Congenital heart defects Hypertensive heart
More informationpost-infarction ventricular septal rupture
Br Heart J 1989;62:268-72 Patterns of coronary artery disease in post-infarction ventricular septal rupture J D SKEHAN,* CATHERINE CAREY,* M S NORRELL,t M DE BELDER,* R BALCON,t P G MILLS* From The London
More informationECG in coronary artery disease. By Sura Boonrat Central Chest Institute
ECG in coronary artery disease By Sura Boonrat Central Chest Institute EKG P wave = Atrium activation PR interval QRS = Ventricle activation T wave= repolarization J-point EKG QT interval Abnormal repolarization
More informationIndex. radiologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A ALCAPA. See Anomalous left coronary artery from the pulmonary artery. Angiosarcoma computed tomographic assessment of, 809 811 Anomalous
More informationTHE VESSELS OF THE HEART
1 THE VESSELS OF THE HEART The vessels of the heart include the coronary arteries, which supply the heart and the veins and lymph vessels, which drain the heart. THE CORONARY ARTERIES These are the blood
More informationMedical Management of Acute Heart Failure
Critical Care Medicine and Trauma Medical Management of Acute Heart Failure Mary O. Gray, MD, FAHA Associate Professor of Medicine University of California, San Francisco Staff Cardiologist and Training
More information2.02 Understand the functions and disorders of the circulatory system
2.02 Understand the functions and disorders of the circulatory system 2.02 Understand the functions and disorders of the circulatory system Essential questions: What are the functions of blood? What are
More informationLarge Arteries of Heart
Cardiovascular System (Part A-2) Module 5 -Chapter 8 Overview Arteries Capillaries Veins Heart Anatomy Conduction System Blood pressure Fetal circulation Susie Turner, M.D. 1/5/13 Large Arteries of Heart
More informationCardiovascular System Notes: Heart Disease & Disorders
Cardiovascular System Notes: Heart Disease & Disorders Interesting Heart Facts The Electrocardiograph (ECG) was invented in 1902 by Willem Einthoven Dutch Physiologist. This test is still used to evaluate
More informationThe Fundamentals of 12 Lead EKG. ECG Recording. J Point. Reviewing the Cardiac Conductive System. Dr. E. Joe Sasin, MD Rusty Powers, NRP
The Fundamentals of 12 Lead EKG Dr. E. Joe Sasin, MD Rusty Powers, NRP SA Node Intranodal Pathways AV Junction AV Fibers Bundle of His Septum Bundle Branches Purkinje System Reviewing the Cardiac Conductive
More informationThis lab activity is aligned with Visible Body s A&P app. Learn more at visiblebody.com/professors
1 This lab activity is aligned with Visible Body s A&P app. Learn more at visiblebody.com/professors 2 PRE-LAB EXERCISES: A. Watch the video 29.1 Heart Overview and make the following observations: 1.
More informationCase Report Thirty Years Later: Evolution of Treatment for Acute Left Main Coronary Artery Occlusion
Case Reports in Cardiology Volume 2016, Article ID 7360682, 4 pages http://dx.doi.org/10.1155/2016/7360682 Case Report Thirty Years Later: Evolution of Treatment for Acute Left Main Coronary Artery Occlusion
More informationAtypical pain and normal exercise test
Atypical pain and normal exercise test F. Mut, M. Beretta Nuclear Medicine Service, Asociacion Española Montevideo, Uruguay Clinical history 67-year old male with several coronary risk factors. Atypical
More informationF or a long time the 12-lead electrocardiogram
490 REVIEW The electrocardiogram in ST elevation acute myocardial infarction: correlation with coronary anatomy and prognosis Y Birnbaum, B J Drew... The electrocardiogram is considered an essential part
More informationThe Heart & Pericardium Dr. Rakesh Kumar Verma Assistant Professor Department of Anatomy KGMU UP Lucknow
The Heart & Pericardium Dr. Rakesh Kumar Verma Assistant Professor Department of Anatomy KGMU UP Lucknow Fibrous skeleton Dense fibrous connective tissue forms a structural foundation around AV & arterial
More informationSPECIAL PATHOPHYSIOLOGY CARDIO-VASCULAR SYSTEM
1. Myocardia lischemia is mainly a result of: 1.Coronary hypoxemia. 2. Coronary artery disease (CAD). 3. Acute coronaritis. 4. Coronary anemia. 5. Heart remodelling. SPECIAL PATHOPHYSIOLOGY CARDIO-VASCULAR
More informationThe Value of Stress MRI in Evaluation of Myocardial Ischemia
The Value of Stress MRI in Evaluation of Myocardial Ischemia Dr. Saeed Al Sayari, MBBS, EBCR, MBA Department of Radiology and Nuclear Medicine Mafraq Hospital, Abu Dhabi United Arab Emirates Introduction
More informationWhat is Your Diagnosis?
What is Your Diagnosis? A STORM R Dulgheru, Liege, Belgium Faculty disclosure Raluca Dulgheru I have no financial relationships to disclose. Case presentation 52 years old male Ongoing oppressive chest
More informationCan be felt where an artery passes near the skin surface and over a
1 Chapter 14 Cardiovascular Emergencies 2 Cardiovascular Emergencies Cardiovascular disease has been leading killer of Americans since. Accounts for 1 of every 2.8 deaths Cardiovascular disease (CVD) claimed
More informationRole of right ventricular infarction in cardiogenic shock
British Heart Journal, 1979, 42, 719-725 Role of right ventricular infarction in cardiogenic shock associated with inferior myocardial infarction1 HENRY GEWIRTZ,2 HERMAN K. GOLD, JOHN T. FALLON, RICHARD
More informationAdult Echocardiography Examination Content Outline
Adult Echocardiography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 4 5 Anatomy and Physiology Pathology Clinical Care and Safety Measurement Techniques, Maneuvers,
More information